Kornimate/medical-research-clean huggingface dataset:
smartwatch paroxysmal arrhythmia detection compared with holter

Conditions: Arrythmia

Summary: the lifetime risk for development of atrial fibrillation, the commonest sustained arrhythmia in adults, is estimated to be 24%-27% for individuals of 40 years or older. previous work showed that annual new diagnosis of af is 11000-26000 in hong kong. other arrhythmia such as supraventricular arrhythmia or premature beats were also common and of clinical significance. 12-lead ecg is a first line investigation for patients with suspected paroxysmal arrhythmia, but it has a low diagnostic yield with its 10-30 seconds recordings. 24-hour holter exam is the usual next step of diagnosis. the diagnostic yield of holter varies according to indication but is generally low at 1%-12%. this is because paroxysmal arrhythmia may not happen every day. in addition, even if arrhythmia is picked up in holter, patient may not register the symptom, making the symptom arrhythmia correlation problematic. despite limitations, the demand for holter exam is still high. in prince of wales hospital, a tertiary referral centre with a catchment of about 1 million populations, the waiting time for a routine holter exam is 3 years. smartwatch has gained popularity over past years as an adjunct to smartphone. latest generations of smartwatch were equipped with wearer-initiated ecg rhythm strip recording capabilities. smartwatch has evolved to become a health tracker with arrhythmia detection capabilities. it was found to be a useful tool for atrial fibrillation screening in general population. other arrhythmias, such as supraventricular tachycardia, premature beats, and abnormal ecg patterns associated with sudden cardiac death could also be detected with smartwatch ecg recordings. apple heart study was the largest study utilizing smartwatch for arrhythmia detection. the general population was screened for atrial fibrillation using irregular pulse algorithm. the study found a 84% concordance rate between irregular pulse notification and ecg patches. therefore, investigators propose to conduct a study to compare its diagnostic yield with holter, in patients with suspected arrhythmia and see if smartwatch recording following a systematic protocol for four-weeks will have better arrhythmia diagnosis yield than a 24-hour holter exam.


Eligibility criteria:
inclusion criteria: 1. all patients referred for out-patient holter exam from age 18 - 80 years old 2. the following indications for holter exam will be allowed for recruitment * palpitation * pre-syncope * dizziness exclusion criteria: 1. patients with a prior ecg diagnosis to explain the symptom 2. primary symptom is syncope 3. patient who has no clear indication for holter exam 4. pregnant ladies 5. patients who failed to make a successful recording despite teaching attempts. 6. patients who cannot read english or chinese version of consent. 7. anticipation of non-compliance with recording protocol. 8. patients who do not have a compatible smart phone (android 9.0 or newer, or ios15 or newer) 9. patients under custody
the prevalence and clinical manifestations of human metapneumovirus among children with bronchiolitis.

Conditions: Respiratory Tract Infection; Children

Summary: sputum specimens will be obtained from children \< 2 years of age and processed by different mode for the hmpv, rsv, pertussis, influenza a, b, parainfluenza 1,2,3, adenovirus. clinical and epidemiological data will also be obtained.

the purpose of the study is to asses the various pathogens of bronchiolitis in children and its' clinical manifestations. prospective study in 3 medical centers in northern israel. included will be about 200 infants and children \< 2 years hospitalized with bronchiolitis. from each child sputum specimen will be obtained and processed for hump - pcr, pertussis - pcr, rsv - elisa, dfa, pcr, influenza a, b, parainfluenza 1,2,3 - dfa, pcr, adenovirus - dfa. epidemiological data will be obtained for every child by structured questioner. clinical data will be daily obtained by scoring system.

Eligibility criteria:
inclusion criteria:age 0-24 months, hospitalized children, - exclusion criteria:previous hospitalization, previous rsv immunization, immunocompromised patient, previous inclusion in this study, inclusion in another study. -

Keywords: child, bronchiolitis,
treatment of constipation in functional dyspepsia

Conditions: Dyspepsia; Constipation

Summary: background. functional dyspepsia is characterized by symptoms that apparently originate in the stomach without detectable cause by conventional diagnosis test. the pathophysiology of functional dyspepsia is not known, but a number of data indicate that dyspeptic patients have increased sensitivity of the digestive system, so that physiological stimuli may induce their symptoms. some patients with functional dyspepsia have also functional constipation and the investigators hypothesize that in them constipation triggers or facilitates dyspeptic symptoms, and consequently, correction of constipation relieves dyspeptic symptoms. objective. to demonstrate the superiority of biofeedback versus a fiber supplement for the treatment of dyspeptic symptoms in patients with constipation due to functional outlet obstruction. design. randomized, controlled parallel trial performed in a referral center. participants. consecutive patients complaining of symptoms of functional dyspepsia and functional outlet obstruction. interventions: patients will be assigned to experimental (biofeedback for functional outlet obstruction) and active comparator (fiber supplementation) arms. biofeedback for functional outlet obstruction: sessions of biofeedback guided by anorectal manometry (performed during the first 3 weeks of the intervention period) combined with instructions for daily exercising for 4 weeks. fiber supplementation: 2.5 g plantago ovata per day for 4 weeks. main outcome and measures. clinical symptoms of functional dyspepsia measured by daily questionnaires for 7 consecutive days before and during the last week of intervention. relevance. functional dyspepsia, defined by purely clinical criteria, brings together a diverse group of conditions with different pathophysiology. as a result, the treatment is empirical and globally inefficient. this study will identify a subset of patients with a common pathophysiological mechanism of dyspeptic symptoms (functional outlet obstruction) which respond to specific treatment (biofeedback).


Eligibility criteria:
patients with functional dyspepsia and functional constipation. inclusion criteria * rome iv criteria for functional dyspepsia type of postprandial distress syndrome. * rome iv criteria of functional constipation * anorectal manometry showing defective sphincter relaxation during the defecatory manoeuver. exclusion criteria: * history of organic gastrointestinal disorders * cognitive impairment.
choline quantification in breast cancer by mrs

Conditions: Breast Neoplasms

Summary: choline has been found in increased concentration in breast cancer patients. hypothesis: the choline signal as observed by mrs is sensitive to treatment, and a positive response to treatment will give a reduction in choline concentration. the purpose of this study is to establish methods for quantification of choline in breast cancer by mrs

1. establishment of new mrs sequence for choline quantification of choline. this sequence is choline-selective, and signals from water and lipids are suppressed simultaneously. 2. compare to different methods for choline quantification. the first method is quantification through an external phantom standard, containing a known concentration of choline. the other method is based on the utilisation of internal water signal as a reference. both calculations can be performed from the same mr exam. ten patients will be included in the study.

Eligibility criteria:
inclusion criteria: * breast cancer exclusion criteria: -
talc pleurodesis in patients with recurrent malignant pleural effusion

Conditions: Recurrent Malignant Pleural Effusion.

Summary: the purpose of this study is to analyze and compare radiological lung expansion after talc pleurodesis performed either by videothoracoscopy or chest tube and correlate it with clinical outcome. secondary endpoints evaluated were: clinical efficacy, safety, quality of life and survival.

talc pleurodesis is the most popular method to control symptoms of recurrent malignant pleural effusion. the intrapleural talc delivery may be by videothoracoscopy and talc poudrage or talc slurry thought a chest tube and the best method is still controversial. although the lung expansion is a key criteria for success of the procedure, its characteristics are poorly studied. patients were enrolled into two groups: videothoracoscopic talc poudrage (vt) and talc slurry through a chest tube (dt). lung expansion was evaluated through chest ct scans obtained obtained in the first 7 days and 1, 3 and 6 months after pleurodesis. all examinations were revised by two independent observers. clinical efficacy (considered as lack of new procedures during follow up), complications, drainage duration, hospital stay and quality of life (general and specific questionnaires) were also analyzed.

Eligibility criteria:
inclusion criteria: * malignant pleural effusion confirmed by cytological analysis of pleural fluid and/or pleural biopsy; * recurrent pleural effusion with symptoms; * chest radiography with lung expansion after thoracocentesis; * karnofsky performance status \> 70; * written informed patient consent were obtained. exclusion criteria: * hemorrhagic diathesis; * active infection; * cutaneous infiltration; * patients unable to understand the questionnaires; * age: \> 90 yo or \< 18 yo.

Keywords: pleural effusion. talc. pleurodesis. quality of life. thoracoscopy.
parametric mapping in paediatric magnetic resonance imaging

Conditions: Cardiac Disease; Pediatric Disease; Cardiomyopathies; Congenital Disorders

Summary: magnetic resonance imaging (mri) is increasingly an important tool for diagnosis and management of cardiac diseases in children. one of the uses of mri is tissue characterisation, in which the signal characteristics of the cardiac muscle (myocardium) can be determined with special techniques, known as parametric mapping. there is increasing evidence that parametric mapping may be able to identify regions of scarring in the myocardium, or detection of oedema/inflammation in the setting. this in turn can help predict disease course and add value to the management of patients. there is also evidence that other structures that are visualised in parametric mapping aside from the heart (e.g. liver and spleen) can also help improve diagnostic accuracy and guide management. currently the majority of studies describing the use of parametric mapping is focused on adults, with limited data on its use in children. the parametric mapping values can also differ amongst different machines, so calibration with normal subjects are also required.

magnetic resonance imaging (mri) can provide tissue characterisation without radiation and need for invasive biopsy. parametric mapping techniques (t1 mapping, extracellular volume fraction, t2 mapping, t2\* mapping) are methods of quantitative analysis of tissue properties, and are currently commercially available. t1 mapping, extracellular volume fraction (ecv) and t2\* mapping provides knowledge about the tissue properties of the myocardium, interstitium and adjacent structures,and can provide information for diagnosis of fibrosis, inflammatory and infiltrative diseases. t2 mapping is useful for assessing oedema, which may be useful in monitoring disease activity such as myocarditis. parametric mapping has proven clinical utility in iron deposition, amyloid disease, anderson-fabry disease and myocarditis. in addition to assessment of cardiac muscle, tissue characterisation can also be performed in adjacent organs that are included in the field of view of parametric mapping (e.g. liver and spleen). parametric mapping may provide important diagnostic information for decision making, patient monitoring and management planning. the investigators aim to 1. recruit healthy volunteers as controls to establish normal local reference ranges for parametric mapping values 2. recruit patients undergoing clinically indicated cardiac mri to perform parametric mapping, and compare the parametric mapping values between normal controls and patients.

Eligibility criteria:
inclusion criteria: * healthy volunteers * paediatric patients \<=18 years of age with suspected or confirmed cardiac disease undergoing clinically indicated mri exclusion criteria: * unstable or uncooperative patients that cannot tolerate mri * patients with contraindications for mri (e.g. patients with implanted devices that are not mri compatible)

Keywords: magnetic resonance imaging parametric mapping
prep readiness interventions for supporting motivation

Conditions: HIV Infections; Pre-exposure Prophylaxis; Substance Use Disorders

Summary: the overarching goal of this formative research is to examine whether, and in what combination, contingency management (cm) and motivational interviewing (mi) can facilitate entry of stimulant-using men who have sex with men (msm) into the pre-exposure prophylaxis (prep) care continuum.

in stage 1, participants will be randomized to receive either: 1) three months of cm; or 2) two sessions of mi. all participants will be assessed at three months post-randomization for non-response. in stage 2, a second randomization where non-responders (i.e., those who have not filled a prep prescription) are assigned to: 1) switch to sequentially receive the other intervention (i.e., cm+mi or mi+cm); or 2) continue with assessments only (i.e., cm-only or mi-only). all participants will complete a final assessment at 6 months.

Eligibility criteria:
inclusion criteria: * at least 18 years of age * sexually active cisgender sexual minority man * reports using stimulants in the past three months * hiv-negative serostatus * meets centers for disease control and prevention (cdc) criteria for prep eligibility exclusion criteria: * currently prescribed prep * unable to provide informed consent * severe psychiatric symptoms (e.g., mania, psychosis) that impair capacity to participate
visual function after implantation of bilateral acrysof® toric natural intraocular lens

Conditions: Cataract

Summary: the purpose of this study is to evaluate the effect that placement and power of the acrysof toric has on post-operative visual acuity and spectacle independence for distance vision. this will be determined by comparing manifest refraction pre-operatively and post-operatively and by evaluating the rotational stability of the lens over time.


Eligibility criteria:
inclusion criteria: * are a candidate for bilateral implantation * in good general and ocular health, 21 years of age or older, of either gender or any race, diagnosed with age-related cataracts in both eyes * in need of spherical correction between 10.0 diopter (d) and 30.0 d * preoperative regular corneal astigmatism, ≥ 1.0 d and ≤ 2.5 d , as measured by keratometry * willing and able to complete all required postoperative visits * able to comprehend and sign a statement of informed consent * pupil dilation ≥ 6.0 mm * expected to achieve a postoperative logmar +0.3 or better visual acuity (as assessed by one or more of the following: fundus examination, pinhole visual acuity, and/or pam evaluation); exclusion criteria: exclusion criteria before surgery - ocular * previous cataract patient without potential of bilateral implantation * females of child bearing potential * irregular corneal astigmatism * keratopathy/keratectasia - any corneal abnormality including but not limited to the following: keratoconus, keratoglobus, keratolysis, keratomalacia, keratomycosis, and cornea plana * any inflammation or edema (swelling) of the cornea, including but not limited to the following: keratitis, keratoconjunctivitis, and keratouveitis * previous corneal reshaping, including but not limited to the following: keratomileusis, radial keratotomy (rk), photorefractive keratectomy (prk), laser in situ keratomileusis (lasik), thermal keratoplasty (tk), and penetrating keratoplasty (pk) * clinically significant corneal dystrophy (including fuch's dystrophy) * previous corneal transplant * amblyopia * glaucoma (medically uncontrolled) * clinically significant rpe/macular changes * proliferative diabetic retinopathy * history of macular edema * previous history of retinal detachment * history of uveitis/iritis * extremely shallow anterior chamber, not due to swollen cataract * iris neovascularization * microphthalmos * absent eye or eye with no light perception (nlp) as fellow eye * rubella, congenital, traumatic, or complicated cataract * optic atrophy exclusion criteria during surgery * other procedures at this surgery * limbal relaxing incisions (lris) or any other procedure to reduce the amount of preoperative astigmatism on the study eye(s), whether implanted with sa60tt or sa60at, for the duration of the study

Keywords: cataract acrysof toric iol bilateral cataract
randomized controlled trial comparing slow-freezing to vitrification of oocytes

Conditions: Infertility

Summary: preservation of fertility is limited. current methods include embryo cryopreservation and while still experimental, ovarian cryopreservation. in single women who are at risk for infertility secondary to cancer or couples who have ethical reasons to avoid embryo cryopreservation, oocyte cryopreservation is an alternative purpose of study is to compare slow freeze to vitrification of human oocytes. successful cryopreservation and subsequent thawing programs are characterized by avoiding ice crystal formation.vitrification, newer alternative to slow freeze method, process by which water is prevented from forming ice. our hypothesis is that higher survival rate per oocyte is to be expected in the vitrification group.

although several reviews of smaller studies of cryoprotectant methodology exist randomized controlled trials,comparing slow-freeze-rapid-thaw procedure to vitrification of oocytes, are not available. the purpose of this study is to compare these two methods of oocyte cryopreservation in human oocytes.

Eligibility criteria:
inclusion criteria: * 14 or more oocytes at ovum pick up * age \< 38 * bmi \< 30 exclusion criteria: -

Keywords: human oocyte cryopreservation slow-freeze vitrification
subtotal resection of large acoustic neuromas with possible stereotactic radiation therapy

Conditions: Neuroma, Acoustic

Summary: the investigators study is to investigate safety and efficacy of performing a planned incomplete removal of large acoustic neuroma tumors to decrease surgical morbidity and yet avoid tumor recurrence by post-operative radiation therapy.

the current standard treatment of a large tumor of the balance nerve (acoustic neuroma or vestibular schwannoma) is surgical resection. complete removal of such tumor is associated with significant risks of hearing loss and facial paralysis whereas incomplete removal of the tumor is associated with significant risks of regrowth. stereotactic radiation is a well accepted therapy aiming at stopping the growth of smaller acoustic neuromas before their sizes become large enough to cause problems. the purpose of our study is to determine whether the combination of subtotal resection followed by stereotactic radiation of the remnant can control large acoustic neuromas without the significant risks associated with complete resection.

Eligibility criteria:
inclusion criteria: * adult patients with acoustic neuromas the widest diameter of 2.5 cm or larger at the cerebellopontine angle are eligible for this trial. * patients that are deemed good surgical candidates based on age, general health, genetic predispositions, and hearing in contralateral side would be included as the subjects of this trial. * although we would include patients with neurofibromatosis ii in this trial, considering their genetic predisposition for recurrence, we would analyze their outcome as a separate group. exclusion criteria: * patients who have received any form of treatment of their acoustic neuromas prior to enrollment in the study including surgery or radiation therapy.
treatment of breakthrough pain in opioid tolerant cancer patients

Conditions: Pain; Cancer

Summary: the purpose of this study is to evaluate the safety and tolerability of oravescent fentanyl when used long-term to relieve breakthrough pain in opioid tolerant cancer patients.


Eligibility criteria:
inclusion criteria: * documented diagnosis of a malignant solid tumor or hematological malignancy causing cancer related pain * currently taking around the clock opioid therapy for pain * experience on average, 1-4 breakthrough pain episodes per day exclusion criteria: * opioid or fentanyl intolerance * sleep apnea or active brain metastases with increased intracranial pressure * copd (chronic obstructive pulmonary disease); cardiopulmonary disease; heart disease

Keywords: cancer pain breakthrough pain in cancer patients
soltive™ laser enucleation for treatment of benign prostatic hyperplasia

Conditions: BPH; Benign Prostatic Hyperplasia

Summary: to compare intraoperative as well as postoperative outcomes of soltive thulium fiber laser enucleation of the prostate (thuflep) vs holmium laser enucleation of the prostate. our hypothesis is that utilizing the soltive thulium laser enucleation of the prostate will result in a more efficient procedure, comparable results to that of holmium laser enucleation of the prostate and subjective improvement of prior device limitations

thulium laser is continuous wave laser which offers numerous potential benefits compared to alternative lasers and surgical procedures used for bph. the soltive laser system is a compact system which is significantly smaller than holmium laser systems. the laser fiber is also smaller in diameter allowing for improved maneuverability with decreased fiber degradation and endoscope damage. the continuous wave pattern produces fast, hemostatic cuts during the removal and furthermore the associated hemostasis improves the visual field. additionally, based on the 1940nm wavelength is absorbed nearly five times more in water. for all the stated reasons, the soltive thulium laser should improve the enucleation efficiency and warrants further investigation.

Eligibility criteria:
inclusion criteria: 1. patients must be 18 years of age or older 2. patients must be diagnosed with benign prostatic hyperplasia 3. patients must opt for surgical management of their bph with laser enucleation exclusion criteria: 1. patients with a concomitant neurogenic bladder diagnosis (sci, parkinson, ms, cerebral palsy) 2. patients with prostate glands greater or equal to 200 grams 3. patients who are enrolled in other surgical or interventional trials at the time of this study are not eligible.